ICU rotation objectives

During an ICU rotation for school you are NOT going to learn how to be an ICU nurse, there are too many things to learn that only experience can teach. If I had a rotation in the ICU my main goals would be to gain a basic familiarity with the equipment, Ok that's an IABP what does it do, ok it keeps the aorta from collapsing during diastole increasing coronary and renal perfusion (keeps the aorta larger, allows more blood through). Just gain a basic knowledge of the equipment, don't try to learn the ins and outs of hemodynamic monitoring and weaning the balloon pumps, etc... that will be learned in critical care courses etc... Also get a feel for what it is like to work in an ICU; patient load, clinical experience, knowledge required, etc... Our clinicals are for one purpose, familiarize us with the equipment and get us comfortable dealing with patients, families, and other members of the health care team........it keeps us from graduating and being first day on the job stumbling with a bp cuff or being nervous around patients and families, etc.... The real learning, advanced things, starts when you graduate and take, ACLS, critical care courses, tele courses, and get experience.

I am currently in a ICU rotation in nursing school in FL. We need to list our objectives for the course (what we hope to get out of it). Does anyone who works in an ICU have some suggestions for basic ICU care? Such as, types of equipment we may be dealing with (vents, pumps). Any suggestions would be appreciated. Thanks!

I would agree with JiffyGriff, that you want to be able to identify some of the devices and their functions:

Here are some objectives I have come up with just off the top of my head:

1. How to read the monitors

a. Setting alarms appropriately for the patient

2. Identifying various invasive lines

a. Peripheral IV

b. Art line

c. PICC line

d. Triple Lumen

(That, in itself, is important, because you want to be able to understand the IV access that your patient has)

3. Identifying all the drugs your patient has going in: (Not necessarily exactly what they do, although that would be nice, but the lay of the land)

Example: I've got maintenance fluids of 0.9 NS going into pt in one port of triple lumen, I've got a morphine PCA with a continuous rate of 1 mg/hour hooked into another KVO (keep vein open) line of 0.9NS running at 10cc/hour (why might I do this??),etc. Where might I hand this piggyback of Zosyn??

4. Understand the basic assessment of the patient. (Hmmm...belly distended, is it more distended than before?? How do lungs sound? Any skin breakdown, etcl)

5. Understand the challenges of caring for an immobile patient (turning, boosting in bed, changing linens of pt who probably can't help you).

The above skills then allow you to assess your patient, their fluids, their status, and their IV access. It helps you "map out" the patient. Now, now about some basic skills??

1. Zero an art line, draw blood from it

2. Set alarm parametes on the monitor

3. Take an IV pump, and go somewhere quiet with a few (small) bags of 0.9 (and a plastic wastebasket) and mess around with it. Learn how to set up the piggyback if you haven't already learnedit. (My nursing school was HORRIBLE about teaching us about IV pumps-they wheeled one in, say, "Here it is!", and wheeled it out.

4. If your preceptor is okay with it, practice starting some IVs. I was a real chicken about it, and practiced on rolled up towels taped in a cylinder form (yeah, I know, stupid), but it helped me get the hand movements down.

So, you want to learn how to ASSESS the patient and all her/his devices, drains, IV access, etc. Learn how to use a few devices (IV pump, art line).

Also, ask lots of questions (or write down and ask later).

Good luck!

Oldiebutgoodie

Oh, also, have preceptor, instructor, or a respiratory therapist give you a "guided tour" of a vent and some of the settings on it. Know about VAP (Ventilator Associated Pneumonia) and oral care of vented patients.

Oldiebutgoodie